Partograph is a Greek word which means “Labour Curve”. Partograph or Partogram is a simple, Inexpensive tool which gives continuous pictorial overview of labour. It is the easy way to detect prolonged labour. The common obstetric Emergencies are obstructed labour and prolonged labour. Obstructed labour means no progress in descending parts inspite of good uterine contractions and the appropriate management would be the Caesarean section. In Prolonged labour the Cervix dilates slowly and incompletely and vaginal delivery may be considered under medical supervision. Obstructed and Prolonged labour complications are rupture of uterus, fetal distress and fetal Death. Slow progress in labour results in postpartum hemorrhage (PPH), Infections and Obstetric fistulae. To prevent life threatening situations in labour it is important that the signs of Obstructed & Prolonged labour identified early in Peripherals where the emergency management facilities are not available.

BACKGROUND:

Friedman is the first Obstetrician to provide a tool for the assessment of individual labour (Cervicograph).In 1972, Philpott developed Partogram from Cervicograph in Zimbabwe and Later Philpott and Castle introduced an ‘Action Line’ & ‘Alert Line’ in the Partogram. John Studd promoted the use of Partograph in United Kingdom.

THE CONCEPT OF PARTOGRAPH:

◆ It is a record of all observations made on a woman in labour ◆ Decision making tool
◆ Implies a functioning referral system with essential Obstetric service ◆ It improves Efficiency and Effectiveness of Maternity Services

DEFINITION:

❖ A Partograph is a tool to help in the management of labour for the identification of women who are not likely to have a normal delivery and who need medical assistance. ❖ Partograph is a chart in which the salient features of labour are entered in a graphic form and it provides the opportunity for early identification of deviations from normal. ❖ A Partograph is a graphical record of progress during labour. Progress measured by cervical dilatation against time in hours & it provides a record of the important conditions of the mother & fetus that may arise during the process of labour.

OVERVIEW:

The Partograph can be used by midwives and health workers with adequate training in midwifery who are able to: ◆ Observe and conduct normal labour and delivery.
◆ Perform vaginal examination during labour and assess cervical dilation accurately. ◆ Plot cervical dilation accurately on a graph against time.

PURPOSE OF THE PARTOGRAPH:

1) To detect abnormal progress of labour as early as possible 2) To prevent prolonged labour
3) To recognize CPD long before obstructed labour4) To assist in early decision on transfer, augmentation or termination of labour 5) To increase the quality and regularity of all observations of mother and fetus 6) To recognize maternal or fetal problems as early as possible

OBJECTIVE OF INTRODUCTION OF PARTOGRAPH:

Partograph facilitates the providers ina) Differentiating between latent and active phase of labour and its deviation from normal b) Monitoring the progress of labour and well being of mother and fetus c) Recognizing the need for action at the appropriate time

FUNCTIONS OF PARTOGRAPH:

◆ Give early warning in prolonged labour.
◆ Moving to the right of the alert line serves as a WARNING for extra vigilance and specific management decisions must be made. ◆ Other observations on the progress of labour also recorded.

COMPONENTS OF THE PARTOGRAPH:

Part I Assessment of fetal condition
Part II Progress of labour
Part III Assessment of maternal condition
Part IV Outcome of labour

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...GOOD DAY!!!
PARTOGRAPH
Made Easy
I. The Partograph
A
tool to help in management of labor
 Guides
birth attendant to identify
women whose labor is delayed and
therefore decide appropriate action
OBJECTIVES
To understand the concept of the WHO
partograph
I.

To explain to mothers the significance of the
graph
II.
To record the observations accurately on the
graph
III.
To interpret the recorded findings, recognize
deviation from the norm, and decide on
timely referral
Monitor during labor…
 Progress


Cervical dilatation
Contraction pattern
 Maternal



well being
Pulse, temperature, blood pressure
Urine voided
 Fetal

of labor
well being
Fetal heart rate and pattern
Color of amniotic fluid
The parts of the
partograph
Progress of labor
Maternal and fetal well-being
D
I
L
A
T
A
T
I
O
N
Alert line
I
L
A
T
A
T
I
O
N
Alert line
Action
Par
Pa
4h
the
th
ale
Conditions that does not need
the use of partograph

Antepartum hemorrhage Multiple pregnancy

Severe pre-eclampsia and
 Malpresentation
eclampsia

Fetal distress

Previous cesarean section
 Obvious obstructed labor

Very premature baby
II. Recording the findings
in the partograph
Start
by labeling the record
with pertinent patient
identifying information.
Plotting the progress of labor
Plot
only the CERVICAL DILATATION
using the symbol “X”
Start
when woman is in...